Obesity and craniofacial structure as risk factors for obstructive sleep apnoea: Impact of ethnicity
Tóm tắt
OSA is the result of structural and functional abnormalities that promote the repetitive collapse of the upper airway during sleep. This common disorder is estimated to occur in approximately 4% of men and 2% of women, with prevalence studies from North America, Australia, Europe and Asia indicating that occurrence is relatively similar across the globe. Anatomical factors, such as obesity and craniofacial morphology, are key determinants of the predisposition to airway collapse; however, their relative importance for OSA risk likely varies between ethnicities. Direct inter‐ethnic studies comparing craniofacial phenotypes in OSA are limited. However, available data suggest that Asian OSA populations primarily display features of craniofacial skeletal restriction, African Americans display more obesity and enlarged upper airway soft tissues, while Caucasians show evidence of both bony and soft tissue abnormalities. Our recent comparison of Chinese and Caucasian OSA patients found for the same degree of OSA severity. Caucasians were more obese, and Chinese had more skeletal restriction. However, the ratio of obesity to craniofacial bony size (or anatomical balance, an important determinant of upper airway volume and OSA risk) was similar between Caucasians and Chinese OSA patients. Ethnicity appears to influence OSA craniofacial phenotype but furthermore the relative contribution of the anatomical factors underlying OSA risk. The skeletal restriction craniofacial phenotype may be particularly vulnerable to increasing obesity rates. Better understanding of craniofacial phenotypes encompassing ethnicity may help improve OSA recognition and treatment; however, further studies are needed to elucidate ethnic differences in OSA anatomical risk factors.
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Tài liệu tham khảo
Marshall NS, 2008, Sleep apnea as an independent risk factor for all‐cause mortality: the Busselton Health Study, Sleep, 31, 1079
Riha RL, 2005, A cephalometric comparison of patients with the sleep apnea/hypopnea syndrome and their siblings, Sleep, 28, 315
Pae EK, 1999, Cephalometric characteristics of nonobese patients with severe OSA, Angle Orthod., 69, 408
Iida‐Kondo C, 2006, Comparison of tongue volume/oral cavity volume ratio between obstructive sleep apnea syndrome patients and normal adults using magnetic resonance imaging, J. Med. Dent. Sci., 53, 119
Lee RW, 2009, Prediction of obstructive sleep apnea with craniofacial photographic analysis, Sleep, 32, 46
Kagawa M, 2007, Body composition and anthropometry in Japanese and Australian Caucasian males and Japanese females, Asia Pac. J. Clin. Nutr., 16, 31
Lee RW, 2009, Craniofacial phenotyping in obstructive sleep apnea—a novel quantitative photographic approach, Sleep, 32, 37